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RE <br /> <br />Dote...,. 4-22-71 <br /> <br />Permit Issued To, Riter H. Dean 585-5554 <br /> <br />Septic ~onk: Minimum liquid ¢opodty with distribution box <br /> <br />Subsurface Disposal Field required /%] ...... L' , ft. <br />LoI survey <br /> <br />MARION COUNTY HEALTH DEPT.,-Sanitation Specifications <br /> {., _~:'. ~ ~ Number...~_-~ <br /> <br />Other requirements: ~.,3. V'~ <br /> q -. ~z'.~,..,. '--hLr~--~. <br /> <br />_Property AddresS, Boulder Street <br />'~.l~) W Jdth of trench __ sq, <br /> <br />~-iA,cfl ~,.~ t'['~'i. O~ b,_~ ,~Q/" "~ -' <br /> Issued by: <br /> <br /> Record Of Individual Sewage Disposal System <br />To Be Completed by Installer <br /> <br />Total number: Living units F~',~ Bedroom~,~/'?~ Boths_,~t~t~,~Bosemenh Yes r-I No <br /> Individual well ~C,~mmunity system <br />Water supply: Public system ...... ~ . <br />Septic tank: Distance from well .'~ / ,feet, Moterlol~No, o~ompartments <br /> ' [.t'. i~ide width <br /> Diameter c~ Ft. Liqui~depth ft. <br /> <br />Tile disposal field: Distribution.box? Yes ~ Nb [] Other ...... <br />Length of each hne ~lr~ '~'/~ ft, <br /> <br />Total length of oll lines ~",..~. l. ft, Distance from: <br />Width of trench -,,~-.~ y~' ft. Well .ft. <br />l'otol square footage ,~ ......... ft, Neare¢ <br />Distance between hnes fl. Lot line: Front ~ Side ~ Rear ~ <br /> -- -- z ' Foundation ft. __ 1¢ <br />Type of filter materi~h Gravel:~Other Depth beneath tile ~ inche~ <br />Depth of filter material over tl[[ - ~ ..... ~inches. Depth of the below original 9round surface /~ , <br /> <br />JUN g 1 1971 <br /> <br />Indlcote Northerly direction. ~ <br />Inspection will not be made until completed form is returned to the Health. Dept, <br /> Signature of Insmll~ ~~',~ .............. <br /> ...... ffl ~ -- ! /VI''~-~ ~ <br /> <br />DATE <br /> <br />System apparently will L~will not ~l <br /> <br />function satisfactorily, and it therefore approved [~z Disapproved [~J <br /> <br />Date <br />Copies: <br /> <br />(1) Orig, HD Files <br /> <br />MARLO 'UNTY "EA LI'H P ..... N <br /> <br /> <br />